Disaster Management

DISASTER MANAGEMENT : DISASTER MANAGEMENT Dr. S. Aswini Kumar. MD Professor of Medicine Medical College Hospital Thiruvananthapuram Kerala, S. India [email protected] 1
What is a DISASTER? : What is a DISASTER? Disaster- dis·as·ter (noun) An occurrence causing widespread destruction & distress; A catastrophe. A grave misfortune. A total failure 2
Natural Disasters : Natural Disasters For some natural disasters like floods and volcanoes, advance warning may be there; for others like earthquakes,tsunami – NO WARNING 3
Man-made Disasters : Man-made Disasters 4 Chemical Plant Explosion Industrial Accident Building Collapse Acts of Terror Video of Terror
What is it? : What is it? Disaster scenarios once seemed merely theoretical have become a disturbing reality 5
Just like apples : Just like apples Disasters in the communities come in all shapes and sizes 6
Small : Small Some impact a small number of people and put intense demands on the health system for a short period E.g. Hooch Tragedy 7
Large : Large Others involve a large number of casualties and reach a plateau only after a latent period, placing heavy continuing demands on the system 8
Why important? : Why important? Hospitals can quickly be overwhelmed in the event of a disaster 9
Developed or not : Developed or not For example, after the terrorist bombing in Bali in 2002,15 patients requiring mechanical ventilation were sent to an Australian hospital 10
Why we are not prepared? : Why we are not prepared? Traditional approach fail Need equipment Need training Needs Rs Rs Rs Rs Rs Fear of the unknown “It can’t happen here” “Not interested” Inherent lethargy 11
So what? : So what? Planning and preparedness, would allow for a better, more efficient use of material and human resources 12
Key Points: : Key Points: 13 Mitigation involves Structural and Non-structural measures taken to limit the impact of disasters
Disaster Management Continuum : Disaster Management Continuum 14
Need for Training : Need for Training Training of a new volunteer group for such eventualities is difficult; training of existing medical and paramedical staff is more realistic 15
Hospitals need to be prepared : Hospitals need to be prepared First institutions to be affected after any form of disasters, are the hospitals; whether natural or man-made. Preparing nurses is important 16
Mass Casualty Incident : Mass Casualty Incident Any incident that exceeds the responder’s or receiving hospital’s capability to treat or transport is a Mass Casualty Incident 17
Disaster Management Plan : Disaster Management Plan A well documented and tested disaster management plan (DMP) is needed for each disaster 18
Slide 19: This is a mnemonic which can help rescuers remember critical information about disaster response and triage 19 D – I – S – A – S – T – E – R PARADIGM
Disaster Paradigm : Disaster Paradigm 20 D: Detection I: Incident Command S: Safety & Security A: Assess Hazards S: Support T: Triage & Treatment E: Evacuation R: Reallocation & Redeployment
D-I-S-A-S-T-E-R Paradigm Detection : D-I-S-A-S-T-E-R Paradigm Detection Internal External Simple clear plan for notification of administration of the presence of a disaster 21
D-I-S-A-S-T-E-R Paradigm Incident Command : D-I-S-A-S-T-E-R Paradigm Incident Command Born in Fire Service Uniform structure Clearly delineated roles /responsibilities Clear chain of command / communication 22
Incident Command System - Basics : Incident Command System - Basics 23 Unified Command Planning Operations Finance Logistics “Commander” “Thinkers” “Getters” “Doers” “Payers”
Incident Command System : Incident Command System An example of chain of command under the Operations Chief. Note the distribution of Branches under COO 24 Incident Command System Chief of Operations
D-I-S-A-S-T-E-R ParadigmSupport : D-I-S-A-S-T-E-R ParadigmSupport State Ministry and the public health departments like DHS and DME; Fire departments; Law enforcing agencies 25
D-I-S-A-S-T-E-R ParadigmAssess Hazards : D-I-S-A-S-T-E-R ParadigmAssess Hazards Be Aware of Secondary Devices! Bombs, Incapacitating Devices, Multiple Snipers/Terrorists, Delay Devices 26
D-I-S-A-S-T-E-R Paradigm Safety and Security : D-I-S-A-S-T-E-R Paradigm Safety and Security Ensure protection of staff handling disasters using personal protective equipment, decontamination and isolation protocols 27
D-I-S-A-S-T-E-R ParadigmTriage : D-I-S-A-S-T-E-R ParadigmTriage For any hospital while responding to a mass casualty event; the goal is to save as many lives as possible with the available resources 28
For example : For example This could mean application of the principles of field triage in casualty; The purpose of which is to determine who gets what kind of care 29
Triage - Definition : Triage - Definition A process of prioritizing patients based on the severity of their condition, in order to treat as many as possible when resources are insufficient 30
What to do? : What to do? All to be treated immediately is impossible, so one has to select the suitable patients for immediate care based on certain criteria 31
Triage Nurse : Triage Nurse The triage nurse should be in view of the waiting area of the casualty at all times and prioritize the waiting patients periodically 32
Triage : Triage The term comes from the French verb trier, Meaning to separate, sort, sift or select 33
Triage – Badge : Triage – Badge It is selected by the Triage Nurse and worn on each patient involved. It helps for any other staff to immediately identify seriousness of the case 34
Triage Tape : Triage Tape Instead of the triage badge, one may use triage tape to be worn around the wrist 35
Duties of a Triage Nurse : Duties of a Triage Nurse Greeting patients and families in a warm, empathetic manner performing brief visual assessments and documenting the assessments triaging patients into priority groups using appropriate guidelines transporting patients to treatment areas when necessary giving reports to the emergency physician, who is treating the patient 36
The Triage Nurse shall : The Triage Nurse shall After ensuring necessary treatment to deserving patients, returning to the triage area; measuring the relevant vital signs for appropriate determination of triage level reassessment of patients remaining in the waiting room, as necessary notifying patients and their families of any unavoidable delays instructing patients and families to notify triage staff of any change in their condition 37
D-I-S-A-S-T-E-R ParadigmTreatment : D-I-S-A-S-T-E-R ParadigmTreatment Medications -Antidotes, antibiotics, immunizations, prophylaxis, chelation 38
D-I-S-A-S-T-E-R ParadigmEvacuation : D-I-S-A-S-T-E-R ParadigmEvacuation A hospital might need to be evacuated either partially or wholly to accommodate casualties; quarantine or divert incoming patients 39
In the event of flooding : In the event of flooding The ground floor services may need to be shifted to higher floors or a make shift operation theatre arranged 40
It could mean : It could mean Minor surgical procedures in victims may have to be undertaken in these areas as it could mean altered level of asepsis 41
It could mean : It could mean Creating alternate care sites in the waiting area or the hospital lobby or corridors which are not normally designed to provide medical care 42
It could also mean : It could also mean Changing roles and strategies for who provides various kinds of care enhancing the scope of nurses, nursing assistants and paramedics 43
D-I-S-A-S-T-E-RReallocation : D-I-S-A-S-T-E-RReallocation Allocating scarce equipment in a way that saves the largest number of lives in contrast to the traditional focus on saving individual lives 44
D-I-S-A-S-T-E-RRedeployment : D-I-S-A-S-T-E-RRedeployment Re-allocating non emergency and non-clinical doctors to emergency areas & recruiting retired or unemployed persons for temporary service 45 Physiology Professor
D-I-S-A-S-T-E-RRecovery : D-I-S-A-S-T-E-RRecovery Reestablish infrastructure Psychological Support/”Local Debriefings” Economic recovery , insurance claims 46
One key component : One key component It is ensuring adequate supplies of qualified health care providers who are available and willing to serve in a Mass Casualty event 47
Periodic Checks : Periodic Checks A hospital's emergency response plan shall undergo periodic assessment and evaluation whether the plan addresses all issues 48
Hospital Disaster Drills : Hospital Disaster Drills An effective and economical way to improve clinicians' knowledge of hospital disaster procedures is computer simulation 49
Purpose of Hospital Disaster Drills : Purpose of Hospital Disaster Drills To make new hospital staff aware of procedures in disaster response and to train hospital staff to respond to a unexpected Mass Casualty 50
Communication is the key word : Communication is the key word Internal and external communications were the key to effective disaster response and updated phone numbers for key players were vital 51
Table Top Exercise : Table Top Exercise It can help to motivate hospital staff to learn more about disaster preparedness video demonstrations can educate a large 52
In India : In India In India and probably in many other countries of the developing world, no statutory body to regulate and accredit this requirement 53
Slide 54: 54 Thank You for the Patient Listening